Midterm - Health Policy Flashcards

Question

What is the Notwithstanding Clause?

Answer 1

Parliament can declare that any piece of legislature is still going to apply regardless of charter of rights and freedom – only apply to section 2 and 7-15 of charter

Answer 2

Treaties - binding Declarations - non- binding Frameworks and Action Plans - strategic documents

Answer 3

Self-enforcement: relying on countries to enforce their agreements domestically Countries may shame other countries for not following it

Answer 4

Sovereignty Variability in Commitment (States may not prioritize international obligations). Funding and resources vary Lack of Centralized Enforcement: (no centralized authority to enforce international treaties).

Answer 5

substantive area of policy over which participants in policy making compete and compromise

Answer 6

the group of people that are involved in the policy making in a specific domain (open or closed)

Answer 7

Have power to make/enforce policies Activities sanctioned by Constitution, Legislature, Executive, Judiciary

Answer 8

Play role in policy process but NO official legal authority Remain important to process

Answer 9

Canadian Food Inspection Agency (food safety) Canadian Institutes of Health Research (CIHR) – fund research Health Canada Patented Medicine Prices Review Board (Ensures that manufacturers' prices of patented medicines are not excessive) Public Health Agency of Canada

Answer 10

Leader/Partner through the administration of CHA (Canadian Health Act) Funder through Canada Health Transfer Guardian/Regulator regulates and approves the use of thousands of products (e.g., medical devices, pharmaceuticals) Service Provider - provides supplementary health benefits to First Nations and Inuit (e.g., pharmaceuticals, vision care, transportation) Information Provider - performs high quality science and research

Answer 11

Role: Preventing chronic disease and injuries Preventing infectious disease Responding to public health threats/emergency preparedness Strengthening intergovernmental collaboration on public health What they do: Provide information Surveillance Grants and contributions

Answer 12

Provides overall direction and leadership for the health system Responsible for: Overall strategic direction and provincial priorities for the health system Developing legislation, regulations, policies, and directives to support those strategic directions Monitoring overall performance of Ontario’s health system Establishing levels of funding for the health care system

Answer 13

Set the agenda Highlight some issues/ignore some issues so shape what we think about Media outcry can have great impact Significantly shape the discourse (i.e. how an issue is talked about) - Who do journalists quote? Usually associated with a specific ideology - Globe & Mail vs. National Post - CNN vs. Fox News Government officials/Interest groups use the media - To bring visibility to their policy - Government uses strategic leaks to gage public opinion

Answer 14

Independent organizations that conduct research Many associated with a specific ideology Academia - Research organizations - Perceived as more neutral ideologically

Answer 15

Groups that claim to represent public interests but in fact are funded by industry Also called Astroturf groups (as they appear to formed by grass roots group) Industry form front groups to do dirty work and keep corporate brand image clean

Answer 16

Ongoing process of trying to persuading legislative/executive branches to enact policies that promote specific interests Organized Want elected officials/bureaucrats to see the problem and its policy solution from their vantage point In public health usually about influencing regulation and legislation Paid lobbyists need to be registered - Registry of lobbyists

Answer 17

Policy making dominated by a small number of elites Government, business, media Policy is dominated by the elites – closed system Difficult for other groups to get in and change any of the rules Criticisms: Assumes elites have same goals, behaviours and interests Assumes other less powerful groups don’t compete with elites

Answer 18

Political theory Political system is relatively open Many groups compete for power Power is broadly distributed Policy is a result of group competition

Answer 19

Central part of elite theory Concentrated and closed policy system dominated by certain actors Have agreed-upon vision of problems, causation and solutions which are represented by symbols It’s difficult for other groups to influence agenda unless society questions this

Answer 20

Compete against elite groups Groups join coalitions to - Advance their goals - Promote common interests Coalitions can - Attract more attention for an issue - Have a unified message - Gain greater access to policy makers - Pool their resources (financial, skillful leadership, supporters, information) Issue specific vs. broad coalitions

Answer 21

The items currently being discussed by policy makers, media, the public A list of problems, their causes and potential solutions What problems are important? Exist at all government levels

Answer 22

The process by which problems and alternative solutions gain or lose public and elite attention The activities of various actors and groups that cause issues to gain greater attention or prevent them from gaining attention

Answer 23

Systemic agenda: any idea that could be considered as long as it does not contradict values/legal/ideological norms of society Institutional agenda: ideas that are seriously being considered by the institution Decision agenda: ideas that are being acted upon; few ideas reach this level

Answer 24

Universality of coverage - everyone is entitled to health services Portability of coverage - can still access services when moving between provinces Reasonable accessibility to services - everyone must have reasonable access to health services Comprehensiveness of service - must have access to all health services provided by hospitals, physicians or dentists (current system not comprehensive) Public administration - must be administered and operated on a non-profit basis by a public authority

Answer 25

Beveridge system Single payer system (government is the single payer) Health care financed through taxes All individuals contribute Contributions determined by salary All individuals are covered

Answer 26

Mandatory Private Insurance Some public healthcare: Medicare - 65 and older and disabled Medicaid - low income Children’s Health Insurance Program - children not admissible to Medicaid Veteran’s Health Administration - military service and veterans

Answer 27

Patient Protection and Affordable Care Act (2010) Mandatory private insurance health care All adults must purchase health insurance for themselves and their families Fines for non-compliance Later abolished at federal level but some states have maintained Children are covered on parents’ plans until age 25 Insurance companies must follow regulations Large employers must provide insurance coverage Expansion of Medicaid Advantages: More Americans are now insured, Can keep insurance regardless of employment status

Answer 28

1947 - Saskatchewan’s Premier Tommy Douglas first introduces a bill on 1st hospital insurance program in Canada (first universal hospital health care plan) 1966 - Federal government introduces national Medicare program (feds pay 50%) 1977 – Feds retreat from 50:50 cost-sharing and replace it with block funding 1984 – Canada Health Act introduced

Answer 29

Establishes the criteria for universal health care across Canada Establishes monetary arrangement between federal government and provinces Called Canadian Health Transfer now 25% of the public funds Provinces must respect the Act in order to receive transfer payments All PTs are responsible for funding the HC systems in their jurisdictions

Answer 30

Mix of public (70%) & private (30%) Public: Hospitals, acute care facilities, long-term care, doctor’s salaries Private: Diagnostic laboratories, occupational and physical therapy centers, and other allied professionals Private health care insurance - available on a group basis (employee benefit) or individual

Answer 31

Medically necessary diagnostic, treatment & preventive services Extended HC services - Long-term residential care (partial) Variation across the provinces on what is considered “medically necessary” Uninsured health services include: Prescriptions Physiotherapy Psychologists, counsellors Foot care Vision correction Dental care

Answer 32

Policy is what we agree to do to get things done Public or private realm

Answer 33

Not confined to the private/personal sphere It’s a matter of public interest Course of action (or inaction) taken (or not taken) by public authorities Government is at the centre Public policy is “whatever governments choose to do or not do. Public policy is the outcome of the struggle in government over who gets what.”

Answer 34

Laws - Statutes/Legislation/Acts: made by legislature - Case law: made a result of judicial decisions Regulations - rules developed by government to administer gov’t activities Services/Programs Money

Answer 35

Someone other than government is doing the regulation Industry regulate themselves Save resources

Answer 36

Includes Health care policy (focus on individual outcomes) - Organization of health care - Health care access – if people have family physician - Health care delivery – hospitals, dental - Resource allocation - Pharmaceutical policy – who’s paying for it, what regulations Public health policy - Policies aimed at improving the health of the population - Focus on addressing the determinants of health (e.g. income, education, housing) - Government has a direct role to play

Answer 37

Policy that aims to impact positively on population health example - Health Canada’s Healthy Eating Strategy

Answer 38

Micro-system – individual Meso-system – social environment (social networks, peers, family, provider) - change social setting Exo-system – physical environment (worksite, school, practice, organizational setting) - change the physical environment Macro-system – community environment (state, local community secctors) - change that is country or province wide (i.e. new sugar tax on soft drinks)

Answer 39

Describes the impact of different types of public health interventions and provides a framework to improve health Socioeconomic factors (base): interventions with the greatest potential impact, are efforts to address socio-economic determinants of health 4th tier: interventions that change the context to make individuals' default decisions healthy (e.g. clean water, safe roads) Long-lasting protection interventions (3rd tier): clinical interventions that require limited contact but confer long-term protection (e.g. immunizations) Clinical interventions (2nd tier): ongoing direct clinical care Counseling and education (1st tier): health education and counseling

Answer 40

Upstream - reach broader segments of society (increased population impact) and require less individual effort (but can be more controversial since actions address social and economic structures of society) Downstream - more focused on individuals rather than entire populations, increased individual effort needed but require less political commitment

Answer 41

Legislation, national and health protection interventions have the highest return on investment Public Health policies are very effective in returning on investment

Answer 42

This model an help situate the context and the channels of influence and help to determine what type of information is required by decision makers 5 stages of the model: - Agenda setting: When a policy and the problem it's intended to address are acknowledged to be of public interest - Policy formulation - Public administration examines the various policy options it considers to be possible solutions - Adoption (or decision making) - Stage where decisions are made at the governmental level, - Implementation - Policy's implementation parameters are established (can effect the outcome of the policy) - Evaluation - Policy is evaluated, to verify whether its implementation and its effects are aligned with the objectives that were explicitly or implicitly set out

Answer 43

Discussion agenda - includes issues that have become highly visible and become subject of discussion Decision agenda - list of issues the government has decided to address

Answer 44

Advantages simplifies complex process of public policy - Identify moments in life of public policy and adapt info sharing, persuasion and action strategies as appropriate - Maps out legislative and administrative processes involved Limitations - oversimplifies - shows policy making as rational - considers the actors but not their power differential - doesn't reflect reality - stages of policy process often run parallel

Answer 45

Includes Structural environment (e.g. constitution, federalism) Social environment (e.g. ethnic makeup of population, aging population, labour force participation) Economic environment (e.g. GDP, unemployment rate, inflation rate, Gini coefficient) Political environment (e.g. party in power)

Answer 46

Explains when policy change occurs -Three streams that come together in “windows of opportunity” to cause policy change - problem stream: the issues that policymakers and the public perceive as problems. It involves the identification and recognition of issues that require government action, often influenced by events, statistics, or reports. - politics stream: political context, such as the current administration's priorities, public opinion, interest group activities, and the overall political climate. - policy stream: potential solutions and proposals developed by policy experts, researchers, and interest groups. These solutions often undergo a process of discussion, refinement, and evaluation to determine their feasibility and effectiveness.

Answer 47

an opportunity to make a change to a policy (i.e. new evidence or controversy so more people are paying attention and calling for the change) Right people in power, right policy and focus on issue align to create policy window

Answer 48

Long periods of stability (little policy change) punctuated by short periods of change Explains why sometimes policy is incremental others times there are big policy shifts Interaction of policy image and policy venues Punctuated equilibrium model is the interaction between policy image and policy venue and impacts political subsystems (subsystems thrive when images are positive, attention is limited and policy venues are favourable) They mutually reinforce each other (negative or positive feedback) - If policy venue remains unchallenged and retains monopoly then image change is unlikely (positive policy images that protect subsystems don't encourage involvement of new policy venues) Punctuation can occur by Mechanism for discontented = change policy image, expand conflict to include actors previously uninvolved and shop for new policy venues

Answer 49

The way in which a public policy is discussed in public and in the media It encompasses the values, beliefs, and narratives associated with a particular policy issue. Positive image often leads to incremental changes and negative leads to punctuation (positive image protects a subsystem)

Answer 50

The institutional locations where authoritative decisions are made concerning a given issue Each policy venue can have different decision-making bias due to varying participants, values, concerns and decision-making processes The choice of venue can influence the types of policies that are proposed and the likelihood of their adoption. Certain venues may be more conducive to change

Answer 51

Benefits of a policy can be concentrated to a certain group or distributed across large number of people Costs of policy can be concentrated on certain group or distributed across large group of people

Answer 52

Policies can Accomplish their intended goals Misfire - Unintended consequences, Worsen a problem it was intending to improve Fail to accomplish their intended goals

Answer 53

Objective vs. subjective evidence Evidence can be useful and can play an important role It is one input in the decision-making process Not always necessary

Answer 54

substantive area of policy over which participants in policy making compete and compromise”

Answer 55

the group of people that are involved in the policy making in a specific domain -some communities are open (anyone can participate), others are closed

Answer 56

Situational factors - can be sudden or violent events Structural factors - a radical change in political leadership can trigger health policy change - Demographic and social factors are also structural determinants Cultural factors - political and cultural environment can influence levels of participation and trust in government and the possibility of political change Environmental factors - external or international factors

Answer 57

This framework holds that policy developments and choices are influenced by actors' interests and ideas, and institutions Interests (e.g. economic, professional, political) - the agendas of groups of people Ideas - Knowledge or beliefs about what is (e.g. research knowledge), views about what ought to be (e.g. values), or combinations of the two - Values can influence how different societal actors define a problem and how perceive different policy options to be effective, feasible and acceptable Institutions - government structures (political arrangement of a country), Policy networks (unite the government with actors outside of the formal process of government) and policy legacies (constitution and past policies) - can shape and constrain policy developments

Answer 58

Astroturfing - pretending group represents the little guy (make public feel like group is on their side and interests under attack by government and elite) Shooting the messenger - discrediting critics by mocking them (marginalizing them) Buying science - paying for research, hiring scientific experts as spokespeople, placing science stories in media without disclosing conflict of interest Fearmongering - preying on people's fears (especially related to economy) - lose tons of jobs

Answer 59

For understanding how issues gain attention in public policy Power - Refers to the power to persuade and to elicit action Perception - Refers to the representation or impressions of an issue (how issues are framed and understood by public and policymakers) Potency - Refers to the severity or seriousness of consequences of an issue Proximity - Refers to the closeness or imminence of impacts

Midterm - Health Policy Flashcards

(83 cards)